Surgical instrument



April 2, 1963 B. H. RAMSAY 3,083,711

SURGICAL INSTRUMENT Filed May 25, 1961 2O 25 Fl 6. 2 24 26 F163. FIG.4.

INVENTOR. BEATTY H. RAMSAY A TTORN E Y5 Efiddfill Patented Apr. 2, 1%63 This invention generally relates to surgical instruments and more particularly concerns a surgical tool for use during the conduction of operations in controlling hemorrhagrng from blood vessels or the like and in protecting the terminal portions of the incision or Wound. The instrument may be termed a hernostatic towel clamp in that it functions both as a means of retaining skin towels along the wound margins and at the same time to control bleedng from the skin and subcutaneous tissue without crushmg, application of heat, or introduction or" foreign material.

T he surgical instrument of the present invention is most advantageously employed in conjunction with the thoracic region in which operative techniques normally require lengthy incisions; however, it will be appreciated that the tool may also be applied in conjunction with other operative procedures characterized by similar conditions.

in conventional practice, a surgeon performing an operation in the thorax, after making the incision, will normally arrest bleeding from the tips of severed blood vessels by employing a plurality of hernostats or similar clamping e ices. Thereafter, the trunk of the vessel is closed oil by a ligature and the respective hemostats removed. After the completion of ligation and the removal of all hemostats, a towel is normally clamped to the sidewalls of the incision Opening and positioned along the marginal edges of the skin bordering the wound.

it will be appreciated that the application or" the hemostats, the formation of the ligatures, and the subsequent removal of the hemostats prior to the application of the protective towel is a time consuming procedure which oftentimes may cause loss of blood adversely affecting the patients condition as well as causing inconvenience to the operating surgeon.

it is, therefore, an object of the present invention to provide a surgical tool designed to eliminate the necessity of applying and removing ernostats or other clamping devices during the course of an operation, and also to effect a saving in the use of suture material.

Another object or" the present invention is to provide a surgical tool which may be manipulated with facility and yet which is simply constructed with a minimum number of parts. Another object of the present invention is to provide a surgical instrument in the form of a hemostatic towel clamp, wherein bleeding may be controlled and yet in which slain and tissue injury is positively avoided.

Another object of the present invention is to provide a surgical instrument in the form of a hemostatic towel clamp, in which the design is such as to control the bleeding from the skin and subcutaneous tissues by indirect compression exerted through intermediate tissue rather than by direct compression of the blood vessels involved, whereby the possibility of damaging the skin is avoided.

A further object of the present invention .is to provide a surgical instrument in the form of a hemostatic towel clamp which substantially eliminates the loss oi blood from, or the need for ligating or fulgurating bleeding vessels in the skin and subcutaneous tissue.

Still another object of the present invention is to provide a surgical instrument which embodies with modification certain of the conventional elements of similar instruments or apparatus.

These and other objects and advantages of the present invention are generally achieved by providing in a surgical instrument a first plvotable jaw member and a second pivctable jaw member co-functioning with the first pivotable jaw member in a iven longitudinal plane. Conventional lever means are provided for opening and closing the jaw members. In addition, in a preferred construction ratchet locking means of the usual form are associated with the lever means to lock the jaw members in any given disposition relative to each other.

A first lateral member or bar is rigidly coupled to the free end of the first jaw member, and a second lateral member or bar is rigidly coupled to the free end oi the second jaw member. The first lateral member and the second lateral member are provided for and spaced such as to function as tissue compression members. These lateral members cooperatively define a given transverse plane relative to the longitudinal plane of the jaw members upon closure of the jaw members.

At least one prong is connected to the first lateral memher or bar, and at least one prong is connected to the second lateral member or bar. The prongs function to pierce the towel and underlying tissue and extend in directions, relative to the respective lateral members, so as to Us in opposing relationship and to lie in a plane substantially parallel to and adjacent the given transverse plane upon closure of the jaw members. In consequence, the piercing application of the prongs will occur in substantially aligned underlying relationship to the compressive application of the lateral members.

A better understanding of the present invention will be had by reference to the drawings, showing merely an illustrative embodiment, and in which:

FlGURE l is a perspective view of the surgical instrument of the present invention;

FIGURE 2 is a sectional view or a skin incision illustratin the application of the surgical tool of the present invention in performing the dual function of clamping a towel to the marginal edge of the skin adjacent the wound and at the same time compressing the trunks of blood vessels extending into the wound opening, it being noted that the instrument is reverse from its position of PEG- URE 1 and that only the jaw portion of the instrument is shown;

FIGURE 3 is a partial edge view of the sidewalls of the incision showing more clearly the compression of the tissue by the instrument, the towel not being shown in 3 this View for clarity of illustration; and,

FIGURE 4 is a side view of a part of the instrument illustrating the alignment of the prongs and bars in a substantially common plane.

Referring now to the drawings, there is shown in FIG- URE l a surgical instrument according to the present invention which may be termed a hernostatic towel clamp. The instrument comprises finger loops 1d and 11 which co-function through a ratchet locking means 12 to operate lever members 13 and 14, which may be generally denoted as lever means 15.

The lever means 15 pivot at P to jaw members 16 and 17 comprising jaw means 18. The jaw member 16 and the jaw member 17 both lie in the same longitudinal plane. The jaw member 16 has connected to its distal end portion a laterally extending member or bar 19 from which extend a plurality of prongs 2%. Similarly, the jaw member 17 has connected to its distal end portion a lateral member or bar 21 having extending therefrom a plurality of prongs 22.

It is preferable that the bar 19 have at least two prongs 20 extending therefrom, preferably disposed at the terrninal ends of the bar ll". Similarly, it is preferable that the bar 21 have at least two prongs 22 extending therefrom at the end portions of the bar 21. Central prongs 2t) and 2.2 in oppositely disposed relationship may also be provided.

Certain important features of the surgical instrument of the present invention may now be described. It is to be noted that the lateral members or bars 19 and 21 lie in a plane which is transverse to the longitudinal plane of the jaw members 16 and 17; An important feature of the present invention residesin the fact that the oppositely disposed prongs 2t} and 22, at such time as the jaw members 16 and 17. are brought to a closed position, also lie in a transverse plane which is adjacent to and parallel to the transverse plane defined by the. bar members 19 and 21 when the jaws 16 and 17 are in a closed position.

This latter feature of the present invention is more clearly illustrated by reference to FIGURE 4. In this view, the line R represents the plane of the lateral members or bars 19 and 20 as the jaw members 16 and 17 are brought to an at least partially closed position. It will be seen in this view that the prongs 20 and 22 lie in the same transverse plane represented by the line R. Al-

' though some deviation is possible according to manufacturing tolerances, and although a certain degree of nonalignment will occur according to the degree of closure, it

is essential and important to the present invention that the prongs lie in a plane which is at least parallel to and adjacent the plane of the bars at such times as the jaw members are brought to a position of normal closure.

It is also important that the bars .19 and 21 remain in parallel spaced relationship as the jaws 16 and 17 are closed. It is apparent from the view of FIGURE 1 that this particular design feature is embodied in the hemostatic towel clamp of the present invention. Otherwise, it would be conceivable for one pair of opposing ends of the bars 19 and 21 to reach a more fullyclosed position than the other opposing ends, whereby bleeding would be controlled in one'portion of the wound margin and not in another portion.

Towards this same objective, it is essential that the instrument be designed such that the bars 19 and 21 never come into engagement with each other or even approach such engagement whereby the possibility of crushing of blood vessels or skin could occur. stop means as shown at S may be embodied in the pivot means in a manner well known in the art in. order to ac-' 7 is positioned near the skin 23 adjacent the skin sidewalls 25 such that the jaw means 18 may be applied to secure the edge. portion of a towel to the skin 23 and sidewalls.

25. For illustration, the skin 23 may be considered as 7 consisting of an outer skin layer 23a, subcutaneous tissue 23b, and muscle 23c. Normally, the jaw means 18- are pierced into the layers 23:: and 23b. V

In the operative procedure, after the wound 24 has-been formed, instead of'applying hemostats or other clamping devices, the surgeon merely places the towel 27 over the skin 23'such that an edge portion (as heretofore mentioned) is adjacent the sidewalls 25 of the wound. There after, the jaw means 18 is positioned as illustrated in FIG- URE 2 and the lever means 15 is actuated to close the opposing prongs 20 and'22. In this procedure, of course, the prongs are so positioned that they will pierce through the edge portion of the towel 27 and through the skin surface 23 and upper portion of the sidewalls 25, or'more particularly the outer skin layer 23a and subcutaneous layer 23b. In accordance with an important feature of the present invention, as the prongs 20 and 22 are brought Preferably, positive close off the trunks of the blood vessels 28. By proper spacing of the lateral members or bars 19 and 21 at a given radius or distance from the pivot point P, it will be apparent that the bars 19 and 21 will not come in contact with each other but will still be spaced a given distance apart upon closure of the jaw members is and 17, assuming conventional stop means S near the pivot point P. Thus, no force will be applied to the blood vessels 23 directly, but only an indirect force by compression of the tissues surrounding the vessels 28. It is also to be noted a that the prongs 2t and 22, in view of the uni-planarrelationship illustrated in FIGURE 4 will also be disposed at the same distance or radius from the' pivot point P such that they will be acting in alignment with the bars 19 and,

In consequence, with the improved construction of the surgical tool or hemostatic towel clamp of the present invention, at the same time the prongs and 22 are piercing and clamping the towel 27 to the skin-23, the lateral members or bars 1% and 21 are serving to close off and arrest hemorrhage from the blood vessels 28 protruding from the sidewalls 25 of the incision or wound.

Of course, it is evident that a similar operative technique is required with respect to the sidewalls 26 of the wound 24 before the operation is completed.

It has been found through actual usage that the surgical instrument or hemostatic towel clamp of the present invention completely eliminates the loss of blood or the need for ligating or fulgurating bleeding vessels in skin and subcutaneous tissue. It furthermore results in a saving of suture material, and it is readily susceptible of operation to perform its dualfunction. in retaining skin' towels and controlling bleeding. This instrument further significantly simplifies the operative techniqueand yetstill enables a conservative operative procedure with a savings in time accompanied by the resultantadvantages to the patients operative condition. Furthermore, the tool enables the natural body mechanism for clotting bleeding to function to arrest hemorrhage prior to the removal of the tool whereby the necessity for applying ligatures is eliminated.

together, the lateral members-or bars Hand 21 will'com- This application is a continuation-impart of applicants co-pending application, Serial No. 771,876 filed November 4, 1958, entitled Surgical Instrument.

What is claimed is: r v

l. A surgical instrument for retaininga towel along the marginal edges of an incision and for compressing the tissue adjacent thereto, said instrument comprising: a first pivotable jaw member; a second pivotable jaw member co-functioning with said first jaw member in a given longitudinal plane; means for opening and closing said jaw members; a firstlateral elongated member rigidlycoupled to the free end of said first jaw member; a second lateral elongated member rigidly coupled to thefree end of said second jaw member, said first lateral member and said second lateral member being provided for and spaced such as to function as tissue compression mem bers, and said first lateral member and said second lateral member cooperatively defining a given transverse plane relative to said plane of said jaw members up'on closure of said jaw members; at least one prong connected to and extending from one portion of said first lateral member; at least one prong connected'to and extending from one portion of said second lateral member, the remaining portion of each of said lateral members being of substantially greater length, said prongs functioning to pierce said towel andunderlying tissue and extending in directions, relative to said, respective, lateral members so as to be in opposing relationship and to lie in a plane substantially parallel to and adjacent said given transverse plane upon closure of said jaw members, and such that the piercing application of said prongs will occur in substantially aligned underlying relationship to the compressive application of said remaining portion of each of said lateral members.

2. A surgical instrument, according to claim 1, in which each of said prongs is of tapered needle-like construction.

3. A surgical instrument for retaining a towel along the marginal edges of an incision and for compressing the tissue adjacent thereto, said intrument comprising: a first pivotable jaw member; a second pivotable jaw member co-functioning with said first jaw member in a given longitudinal plane; means for opening and closing said jaw members; a first lateral member rigidly coupled to the free end of said first jaw member; a second lateral member rigidly connected to the free end of said second jaw member, said first lateral member and said second lateral member being provided for and spaced such as to function as tissue compression members, and said first lateral member and said second lateral member cooperatively defining a given transverse plane relative to said plane of said jaw members upon closure of said jaw members; at least two spaced prongs connected to and extending from spaced portions of said first lateral member; at least two spaced prongs connected to and extending from spaced portions of said second lateral member, the remaining portion of each of said lateral members being of substantially greater length, said prongs connected to said first lateral member extending, respectively, in opposition to said prongs connected to said second lateral member, and said prongs each functioning to pierce said towel and underlying tissue and extending in directions relative to said, respective, lateral members so as to lie in a plane substantially parallel to and adjacent said given transverse plane upon closure of said jaw members, and such that the piercing application of said prongs will occur in underlying substantially aligned relationship to the compressive application of said lateral members.

4. A surgical instrument, according to claim 3, in which said spaced prongs are connected to the opposite terminal portions of said first lateral member and second lateral member, respectively.

5. A surgical insrument for retaining a towel along the marginal edges of an incision and for compressing the tissue adjacent thereto, said instrument comprising: a first pivotable jaw member; a second pivotable jaw member co-functioning with said first jaw member in a given longitudinal plane; means for opening and closing said jaw members; at least two spaced prongs coupled to the end of said first jaw member so as to lie in a given transverse plane relative to the plane of said jaw members upon closure of said jaw members; at least two spaced prongs coupled to the end of said second jaw member so as to lie in said given transverse plane upon closure of said jaw members, said prongs co-functioning to pierce said towel and underlying tissue; a first lateral member interconnecting said two prongs connected to said first jaw member; a second elongated lateral member interconnecting said two prongs connected to said second jaw member, said first lateral member and said second lateral member each having a substantially greater portion of its length disposed between said prongs, and said first lateral member and said second lateral member being provided for and spaced such as to function as tissue compression members; said first lateral member and said second lateral member lying in a plane substantially parallel to and adjacent said given transverse plane upon closure of said jaw members, and such that said lateral members upon compressive application will overlie in aligned relationship the points where the piercing action of said prongs occurs.

6. A surgical instrument, according to claim 5, in which each of said prongs is of tapered needle-like construction.

7. A surgical instrument, according to claim 5, and means limiting the degree of closure of said jaw members such that tissue injury is avoided.

References Cited in the file of this patent UNITED STATES PATENTS 262,875 Wills Aug. 15, 1882 1,601,035 Nauth Sept. 28, 1926 2,111,161 Wilson Mar. 15, 1938 OTHER REFERENCES Aloe Co. Catalogue, page 247 required (item Bl138), copyrighted 1942. (Copy in Division 55.)

The Gibson Co., Standard Surgical Instruments, page 284, received in Library Nov. 12, 1924. (Copy in Div. 5 5

V. Mueller and Co., Complete General Catalogue, copyrighted 1938, page 376 relied on. (Copy in Div. 55.) 

1. A SURGICAL INSTRUMENT FOR RETAINING A TOWEL ALONG THE MARGINAL EDGES OF AN INCISION AND FOR COMPRESSING THE TISSUE ADJACENT THERETO, SAID INSTRUMENT COMPRISING: A FIRST PIVOTABLE JAW MEMBER; A SECOND PIVOTABLE JAW MEMBER CO-FUNCTIONING WITH SAID FIRST JAW MEMBER IN A GIVEN LONGITUDINAL PLANE; MEANS FOR OPENING AND CLOSING SAID JAW MEMBERS; A FIRST LATERAL ELONGATED MEMBER RIGIDLY COUPLED TO THE FREE END OF SAID FIRST JAW MEMBER; A SECOND LATERAL ELONGATED MEMBER RIGIDLY COUPLED TO THE FREE END OF SAID SECOND JAW MEMBER, SAID FIRST LATERAL MEMBER AND SAID SECOND LATERAL MEMBER BEING PROVIDED FOR AND SPACED SUCH AS TO FUNCTION AS TISSUE COMPRESSION MEMBERS, AND SAID FIRST LATERAL MEMBER AND SAID SECOND LATERAL MEMBER COOPERATIVELY DEFINING A GIVEN TRANSVERSE PLANE RELATIVE TO SAID PLANE OF SAID JAW MEMBERS UPON CLOSURE OF SAID JAW MEMBERS; AT LEAST ONE PRONG CONNECTED TO AND EXTENDING FROM ONE PORTION OF SAID FIRST LATERAL MEMBER; AT LEAST ONE PRONG CONNECTED TO AND EXTENDING FROM ONE PORTION OF SAID SECOND LATERAL MEMBER, THE REMAINING PORTION OF EACH OF SAID LATERAL MEMBERS BEING OF SUBSTANTIALLY GREATER LENGTH, SAID PRONGS FUNCTIONING TO PIERCE SAID TOWEL AND UNDERLYING TISSUE AND EXTENDING IN DIRECTIONS, RELATIVE TO SAID, RESPECTIVE, LATERAL MEMBERS SO AS TO BE IN OPPOSING RELATIONSHIP AND TO LIE IN A PLANE SUBSTANTIALLY PARALLEL TO AND ADJACENT SAID GIVEN TRANSVERSE PLANE UPON CLOSURE OF SAID JAW MEMBERS, AND SUCH THAT THE PIERCING APPLICATION OF SAID PRONGS WILL OCCUR IN SUBSTANTIALLY ALIGNED UNDERLYING RELATIONSHIP TO THE COMPRESSIVE APPLICATION OF SAID REMAINING PORTION OF EACH OF SAID LATERAL MEMBERS. 